Individual
COLIN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 CIVIC CENTER BOULEVARD, 2ND FLOOR, SOUTH PAVILION, PHILADELPHIA, PA 19104-5127
(215) 662-3606
(215) 243-2312
Mailing address
3400 SPRUCE STREET, 3 WEST GATES, PHILADELPHIA, PA 19104-4206
(215) 662-3606
(215) 243-2312
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
Primary
MD458436
PA
2084N0400X
Neurology Physician
MD458436
PA
Other
Enumeration date
05/09/2012
Last updated
11/24/2025
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